Effectiveness of UK radiographer image reading.

PURPOSE: Using quantitative and qualitative methods, this study evaluated the impact of a radiographer image-reading service supporting a minor injuries unit in a UK emergency department. METHODS: Quantitative analysis included a review of key performance indicators before and after implementation of the service and an audit of the radiographers' sensitivity, specificity and diagnostic accuracy. Qualitative analysis involved interviews with emergency department staff. RESULTS: Quantitative: Radiographers read 3778 images during the study period, representing 76.4% of the images that radiographers are qualified to read in the United Kingdom. The number of images read improved from 39.7% (preimplementation) to 80.4% (postimplementation). Timeliness of image reading improved from a preimplementation mean of 10.23 days (SD 7.65) to a postimplementation mean of 5.62 days (SD 4.27). The audit of image-reading radiographers' performance demonstrated a sensitivity of 92.7%, specificity of 99.1% and accuracy of 97%. Qualitative: Emergency department staff valued the input from image-reading radiographers in various ways. For example, the radiographer reading service improved patient management, enhanced the image appreciation skills of nurse practitioners and a physical therapist and improved the working relationship between these advanced practitioners and radiographers. CONCLUSION: The image-reading radiographer service has increased the number of radiographic images read, improved report turnaround times and had positive effects on both patient management and the multidisciplinary health care team.

'I thought it was just an x-ray': a qualitative investigation of patient experiences in cardiac SPECT-CT imaging.

BACKGROUND: Patients attending for complex imaging examinations may experience anxiety and discomfort with associated poor satisfaction and reduced compliance. This may lead to poor quality imaging, repeat scans and nonattendance. Analysing and understanding patient experience to improve the quality of care is of paramount importance within the National Health Service; yet, little published evidence of patient experience research exists within nuclear medicine. This qualitative study aimed to explore the experience of patients referred for cardiac single-photon emission computed tomography-computed tomography (SPECT-CT) in two different clinical environments. METHODS AND RESULTS: Twenty-two patients (13 women, nine men; mean age 63.9 years) were interviewed before and after the procedure to determine their prior knowledge, concerns, expectations and experiences. Thematic analysis demonstrated seven recurring themes: justification, validity of patient information, fear (of their condition, of harm and of the procedure), compliance, role of significant others, mitigation of anxiety, and coping strategies. In most cases an expectation-reality divide was apparent, with the actual experiences of the procedure being in some cases a pleasant surprise, or in other cases a shock. CONCLUSION: Cardiac SPECT-CT patients are often poorly informed and present with a range of anxieties that may ultimately affect examination quality. The imaging team requires an awareness of potential expectation-reality divides, even when there are no overt signs of worry and distress. Written patient information is undoubtedly helpful, but there is no substitute for ongoing and repeated explanations and reassurance by staff. These findings are likely to have implications for other complex nuclear medicine procedures, including noncardiac SPECT-CT examinations and emerging PET-CT applications.